Branded: How Mental Disorder Labels Alter Task Performance in Perception and Reality by Steven ...

130 Pages·2013·0.57 MB·English

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Branded: How Mental Disorder Labels Alter Task Performance in Perception and
Reality

by
Steven Larrimore Foy
Department of Sociology
Duke University

Date:_______________________
Approved:

___________________________
Linda K. George, Co-Supervisor

___________________________
Lynn Smith-Lovin, Co-Supervisor

___________________________
Deborah T. Gold

___________________________
Kenneth I. Spenner

Dissertation submitted in partial fulfillment of
the requirements for the degree of Doctor
of Philosophy in the Department of
Sociology in the Graduate School
of Duke University

2013
ABSTRACT
Branded: How Mental Disorder Labels Alter Task Performance in Perception and
Reality

by
Steven Larrimore Foy
Department of Sociology
Duke University

Date:_______________________
Approved:

___________________________
Linda K. George, Co-Supervisor

___________________________
Lynn Smith-Lovin, Co-Supervisor

___________________________
Deborah T. Gold

___________________________
Kenneth I. Spenner

An abstract of a dissertation submitted in partial
fulfillment of the requirements for the degree
of Doctor of Philosophy in the Department of
Sociology in the Graduate School of
Duke University

2013
Copyright by
Steven Larrimore Foy
2013
Abstract
Extensive evidence demonstrates how mental illness symptomatology can inhibit
perceptions of and actual performance on important tasks. However, receiving
treatment from the medical establishment for such symptomatology requires diagnosis,
whereby the patient becomes labeled and subject to the stereotypes connected to that
label. Mental illness labeling is associated with a variety of negative outcomes including
inhibited access to unemployment, housing, health insurance, and marriage and
parenthood opportunities and can disrupt interpersonal relationships. However, the
repercussions of mental illness labeling for one area of life have remained largely
overlooked; that area is task performance. Adults spend a substantial portion of their
lives at work engaged in group-based or individual level tasks. This dissertation
explores external perceptions of mental illness in task groups and the role of self-
internalization of stereotypes about mental illness in individual task performance
through two experimental studies.
Previous research has revealed that, on average, task partners with a mental
illness are stigmatized and subject to diminished status when they are identified to
participants as having been hospitalized for general psychological problems for an
extended period of time. Study 1 of this dissertation explores the stigma- and status-
iv
based attributions triggered by engaging with a partner in a mutual task who is
identified as having a specific mental illness label: none, Generalized Anxiety Disorder
(GAD), Major Depressive Disorder (MDD), Attention-Deficit/Hyperactivity Disorder
(ADHD), or schizophrenia.
Additionally, research has revealed that members of a group about which
negative stereotypes exist may face a situational threat in a domain relevant task—
stereotype threat. Race, gender, social class, age, and a variety of other
sociodemographic attributes can trigger stereotype threat. However, little research has
considered the potential for stereotype threat to emerge on the basis of mental illness
labeling. Study 2 of this dissertation focuses on individual-level performance, exploring
the potential for ADHD to trigger stereotype threat in test-taking situations.
Results from Study 1 suggest that the specific mental illness labels studied,
presented devoid of symptomatology severity, do not trigger stigmatized attributions
but may trigger some negative status attributions in the case of a task relevant diagnosis.
(ADHD). Study 2 suggests that a task relevant diagnosis may also trigger stereotype
threat in a test-taking situation, negatively impacting performance. Taken together, the
results indicate that task relevance of one’s mental illness label may be a driving factor
in negative external and internal perceptions of mental illness.
v
Dedication

To my best friend and the love of my life, Caity DiSanza. Your intellectual
curiosity keeps my own afire, and your belief in me sustains me.

vi
Contents

Abstract ......................................................................................................................................... iv
List of Tables .............................................................................................................................. viii
Acknowledgements ..................................................................................................................... ix
1. In the Aftermath of Medicalization: Implications at the Intersection of Mental Health
Labeling and Task Performance ................................................................................................. 1
1.1 Medicalizing Mental Illness ............................................................................................ 2
1.2 The Potential Benefits of Medicalization………………………………………………5
1.3 The Potentially Negative Aspects of Medicalized Labeling ....................................... 7
1.4 Medicalized Labeling in Task Performance Scenarios ................................................ 9
1.4.1 Group Level…………………………………………………………………..……...10
1.4.2 Individual Level……………………………………………………………………..12
1.4.3 The Present Studies…………………………………………………………………12
1.5 Organization of the Manuscript ................................................................................... 15
2. Clinically-Constructed Cross-Cubicle Conflict? How Mental Disorder Labels Alter
Perceptions of Task Partners (Study 1) .................................................................................... 17
2.1 Theoretical Background ................................................................................................. 21
2.1.1 Stigma and Mental Illness………………………………………………………….21
2.1.2 Status Characteristics Theory and Mental Illness………………………………..24
2.2 Hypotheses ...................................................................................................................... 29
2.3 Methodology ................................................................................................................... 33
vii
2.3.1 Participant Recruitment…………………………………………………………….33
2.3.2 Procedures…………………………………………………………………………...34
2.3.3 Independent Variables……………………………………………………………...38
2.3.4 Dependent Variables………………………………………………………………..38
2.3.5 Sample………………………………………………………………………………..40
2.4 Results .............................................................................................................................. 43
2.5 Discussion ........................................................................................................................ 49
3. Our Own Worst Enemies: How Mental Disorder Labels Alter Task Performance
(Study 2) ....................................................................................................................................... 54
3.1 Theoretical Background ................................................................................................. 56
3.1.1 Stereotype Threat………………………………………………………………........56
3.1.2 Theoretical Relevance of Adult ADHD to Test-taking and Stereotype
Threat………………………………………………………………………………………62
3.2 Methodology ................................................................................................................... 63
3.2.1 Participant Selection………………………………………………………………...63
3.2.2 Procedures…………………………………………………………………………...66
3.3 Hypotheses ...................................................................................................................... 71
3.4 Results .............................................................................................................................. 73
3.4.1 Sample………………………………………………………………………………..73
3.4.2 Analyses……………………………………………………………………………...76
3.5 Discussion ........................................................................................................................ 83
viii
3.5.1 Limitations…………………………………………………………………………...86
4. Perception is Everything ........................................................................................................ 88
4.1 Summary .......................................................................................................................... 88
4.2 Limitations ....................................................................................................................... 93
4.3 Suggestions for Future Research .................................................................................. 94
References .................................................................................................................................... 98
Biography ................................................................................................................................... 117

ix
List of Tables

Table 1: Study 1 Sample Descriptive Statistics ........................................................................ 42
Table 2: Mean Scores (and Standard Deviations) and Significance Test Results on Stigma
Outcomes ..................................................................................................................................... 45
Table 3: Mean Scores (and Standard Deviations) and Significance Test Results on Stigma
Outcomes ..................................................................................................................................... 47
Table 4: Study 2 Experimental Conditions (Number of Participants) ................................. 67
Table 5: Study 2 Sample Descriptive Statistics ........................................................................ 74
Table 6: Mean Scores (and Standard Deviations) on GRE Sections ..................................... 78
Table 7: Comparing ADHD Participants with Non-ADHD Participants: Mean Scores
(and Standard Deviations) and Significance Test Results on GRE Sections ....................... 79
Table 8: Exposure to Stereotype Threat among ADHD Participants: Mean Scores (and
Standard Deviations) and Significance Test Results on GRE Sections ................................ 80
Table 9: Comparing Exposure to Stereotype Threat among ADHD and Non-ADHD
Participants: Mean Scores (and Standard Deviations) and Significance Test Results on
GRE Sections ................................................................................................................................ 81

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